Introduction: Hypertension is a sustained systolic blood pressure equal to or above 140 mmHg or diastolic blood pressure equal to or above 90 mmHg. The kidneys play a central role in the control of high blood pressure through the renin–angiotensin system. Thus, renovascular changes of myointimal hyperplasia in the intrarenal arteries may cause an increase in renal arterial impedance and eventually irreversible hypertensive nephropathy. The early detection of these renovascular changes using ultrasonography can provide opportunity for immediate intervention toward preventing or at least delaying the irreversible hypertensive nephropathy. Aims and Objectives: The objective of this study is to determine and compare intra-renal resistive index (RRI) in normotensive and hypertensive adults within the age range of 35–70 years at Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: A prospective case–control study of intra-RRI using ultrasound in 150 hypertensive patients and 150 normotensive controls. The mean RRI of the interlobar arteries of both kidneys was measured and recorded. The data were analyzed with the aid of computer-based SPSS 16.0 software for windows. Results: The ages of the study participants ranged between 35 and 70 years. The age difference was not statistically significant (P = 0.88). The mean interlobar artery resistive index (RI) values were 0.59 ± 0.04 and 0.59 ± 0.03 on the right and left sides, respectively, in normotensive controls while those of hypertensive patients were 0.73 ± 0.03 and 0.73 ± 0.03 for the mean interlobar artery RI values on the right and left sides, respectively, and both were statistically significant. Conclusion: The intra-RRIs were lower in normotensive participants when compared with the hypertensive patients which were statistically significant. These showed that hypertension has significant effects on the kidneys, and with early detection and intervention, irreversible renal damage may be prevented.
{"title":"A comparative ultrasonographic evaluation of intrarenal artery resistive index among hypertensive and normotensive adults in north-western Nigeria","authors":"A. Madubueze","doi":"10.4103/wajr.wajr_34_17","DOIUrl":"https://doi.org/10.4103/wajr.wajr_34_17","url":null,"abstract":"Introduction: Hypertension is a sustained systolic blood pressure equal to or above 140 mmHg or diastolic blood pressure equal to or above 90 mmHg. The kidneys play a central role in the control of high blood pressure through the renin–angiotensin system. Thus, renovascular changes of myointimal hyperplasia in the intrarenal arteries may cause an increase in renal arterial impedance and eventually irreversible hypertensive nephropathy. The early detection of these renovascular changes using ultrasonography can provide opportunity for immediate intervention toward preventing or at least delaying the irreversible hypertensive nephropathy. Aims and Objectives: The objective of this study is to determine and compare intra-renal resistive index (RRI) in normotensive and hypertensive adults within the age range of 35–70 years at Aminu Kano Teaching Hospital, Kano, Nigeria. Materials and Methods: A prospective case–control study of intra-RRI using ultrasound in 150 hypertensive patients and 150 normotensive controls. The mean RRI of the interlobar arteries of both kidneys was measured and recorded. The data were analyzed with the aid of computer-based SPSS 16.0 software for windows. Results: The ages of the study participants ranged between 35 and 70 years. The age difference was not statistically significant (P = 0.88). The mean interlobar artery resistive index (RI) values were 0.59 ± 0.04 and 0.59 ± 0.03 on the right and left sides, respectively, in normotensive controls while those of hypertensive patients were 0.73 ± 0.03 and 0.73 ± 0.03 for the mean interlobar artery RI values on the right and left sides, respectively, and both were statistically significant. Conclusion: The intra-RRIs were lower in normotensive participants when compared with the hypertensive patients which were statistically significant. These showed that hypertension has significant effects on the kidneys, and with early detection and intervention, irreversible renal damage may be prevented.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45184784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: A possible increasing trend in the incidence of diverticulosis was observed in adult patients referred to the Diagnostic Radiology department of Dr George Mukhari Academic Hospital (DGMAH), Ga-Rankuwa, Pretoria, for barium enema studies. The study will be the first to document the magnitude of this condition at our hospital since its inception. Objective: The aim of this study is to evaluate the current prevalence of diverticulosis at DGMAH Ga-Rankuwa whose patients are predominantly South Africans of African descent. Materials and Methods: We reviewed the medical records of all adult patients referred to DGMAH for barium enema investigations for 1 year. Barium enema studies of 166 patients who met the inclusion criteria were systematically evaluated radiologically for the presence of diverticulosis. Data from the records were analyzed using the Statistical Package for Social Sciences (SPSS, version 22.0) software program. Results: The patients' ages ranged between 18 and 95 years, with a mean age of 60.1 years. From the records analyzed, 77.7% were radiologically negative, whereas 22.3% were positive for diverticulosis. There was a female preponderance (23 cases [62.2%] among females versus 14 cases [37.8%] among males; P < 0.0001) and the diverticulosis had a diffused pattern. The increasing trend of diverticulosis observed at DGMAH did not reflect any statistically significant difference when compared with previous studies done in sub-Saharan Africa. Conclusion: This study demonstrates a possible trend of diverticulosis previously unrecorded in barium enema studies at DGMAH, probably attributable to the effects of urbanization and higher consumption of refined carbohydrate with low fiber residue.
背景:在比勒陀利亚Ga-Rankuwa Dr George Mukhari学术医院(DGMAH)诊断放射科进行钡灌肠研究的成年患者中，憩室病的发病率可能呈增加趋势。这项研究将是首次记录我院自成立以来这种情况的严重性。目的:本研究的目的是评估目前憩室病在DGMAH Ga-Rankuwa的患病率，其患者主要是非洲裔南非人。材料和方法:我们回顾了所有在DGMAH进行钡灌肠调查的成年患者1年的医疗记录。对166例符合纳入标准的患者进行钡灌肠研究，系统地对憩室病的存在进行放射学评估。使用社会科学统计软件包(SPSS, version 22.0)软件程序对记录中的数据进行分析。结果:患者年龄18 ~ 95岁，平均年龄60.1岁。从分析的记录来看，77.7%的放射学阴性，而22.3%的憩室病阳性。以女性为主，女性23例(62.2%)，男性14例(37.8%);P < 0.0001)，憩室病呈弥漫性。与之前在撒哈拉以南非洲进行的研究相比，DGMAH观察到的憩室病增加趋势没有反映出统计学上的显著差异。结论:本研究显示了一种可能的憩室病趋势，此前在DGMAH的钡灌肠研究中没有记录，可能是由于城市化的影响和低纤维残留的精制碳水化合物的消耗增加。
{"title":"Diverticulosis among patients referred for barium enema studies at Dr George Mukhari Academic Hospital, Ga-Rankuwa, Pretoria, South Africa","authors":"J. Ozoh, G. Ogunbanjo","doi":"10.4103/WAJR.WAJR_39_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_39_17","url":null,"abstract":"Background: A possible increasing trend in the incidence of diverticulosis was observed in adult patients referred to the Diagnostic Radiology department of Dr George Mukhari Academic Hospital (DGMAH), Ga-Rankuwa, Pretoria, for barium enema studies. The study will be the first to document the magnitude of this condition at our hospital since its inception. Objective: The aim of this study is to evaluate the current prevalence of diverticulosis at DGMAH Ga-Rankuwa whose patients are predominantly South Africans of African descent. Materials and Methods: We reviewed the medical records of all adult patients referred to DGMAH for barium enema investigations for 1 year. Barium enema studies of 166 patients who met the inclusion criteria were systematically evaluated radiologically for the presence of diverticulosis. Data from the records were analyzed using the Statistical Package for Social Sciences (SPSS, version 22.0) software program. Results: The patients' ages ranged between 18 and 95 years, with a mean age of 60.1 years. From the records analyzed, 77.7% were radiologically negative, whereas 22.3% were positive for diverticulosis. There was a female preponderance (23 cases [62.2%] among females versus 14 cases [37.8%] among males; P < 0.0001) and the diverticulosis had a diffused pattern. The increasing trend of diverticulosis observed at DGMAH did not reflect any statistically significant difference when compared with previous studies done in sub-Saharan Africa. Conclusion: This study demonstrates a possible trend of diverticulosis previously unrecorded in barium enema studies at DGMAH, probably attributable to the effects of urbanization and higher consumption of refined carbohydrate with low fiber residue.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41308975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: Despite advances in surgical techniques for anterior cruciate ligament (ACL) repair, a significant proportion of patients encounter persisting pain/instability of the knee postoperatively. Objectives: To assess the location of femoral/tibial tunnels on magnetic resonance imaging (MRI) and to correlate the findings with the ACL graft integrity/graft-related complications. Study Design/Settings: This was a cross-sectional study done at Burjeel Medical Centre, Muscat, Oman. Materials and Methods: The study period was between November 2015 and June 2017 on Philips Ingenia 1.5 Tesla MRI machine. A total of 30 male patients, age ranged from 20 to 43 years who presented with knee pain/instability 1 year postreconstruction of ACL, were recruited for the study. Results: Of 30 cases, 10 (33.33%) patients had an intact graft on MRI. Of the remaining 20 patients, graft impingement was noted in 15 patients (50%), graft tear in 3 cases (10%), and graft stretching with abnormal high T2 signal in the remaining 2 cases (6.67%). Associated findings of focal arthrofibrosis in the anterior knee joint space and tibial tunnel cysts were encountered in few patients who were not dealt with in this study. Out of 20 patients with graft abnormality, femoral tunnel was abnormally located in 3 (15%), tibial tunnel was located anterior to the MRI equivalent of Blumensaat's extension line partly or completely in 16(80%) and both tunnels were normally located in 1(5%). Conclusion: The location of the femoral/tibial tunnels is the most important determinant factor of postoperative graft integrity in ACL reconstruction patients.
{"title":"Location of femoral/tibial tunnels in anterior cruciate ligament reconstruction and their impact on graft integrity: Magnetic resonance imaging review","authors":"SushmitaKeerthi Chilkuri, A. Mathews","doi":"10.4103/WAJR.WAJR_37_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_37_17","url":null,"abstract":"Context: Despite advances in surgical techniques for anterior cruciate ligament (ACL) repair, a significant proportion of patients encounter persisting pain/instability of the knee postoperatively. Objectives: To assess the location of femoral/tibial tunnels on magnetic resonance imaging (MRI) and to correlate the findings with the ACL graft integrity/graft-related complications. Study Design/Settings: This was a cross-sectional study done at Burjeel Medical Centre, Muscat, Oman. Materials and Methods: The study period was between November 2015 and June 2017 on Philips Ingenia 1.5 Tesla MRI machine. A total of 30 male patients, age ranged from 20 to 43 years who presented with knee pain/instability 1 year postreconstruction of ACL, were recruited for the study. Results: Of 30 cases, 10 (33.33%) patients had an intact graft on MRI. Of the remaining 20 patients, graft impingement was noted in 15 patients (50%), graft tear in 3 cases (10%), and graft stretching with abnormal high T2 signal in the remaining 2 cases (6.67%). Associated findings of focal arthrofibrosis in the anterior knee joint space and tibial tunnel cysts were encountered in few patients who were not dealt with in this study. Out of 20 patients with graft abnormality, femoral tunnel was abnormally located in 3 (15%), tibial tunnel was located anterior to the MRI equivalent of Blumensaat's extension line partly or completely in 16(80%) and both tunnels were normally located in 1(5%). Conclusion: The location of the femoral/tibial tunnels is the most important determinant factor of postoperative graft integrity in ACL reconstruction patients.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44105729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Aim: In Nigeria today, most radiotherapy (RT) centers do manual planning using anatomical landmarks rather than precise planning using imaging modalities such as Computerized Tomography and Magnetic Resonance Imaging. This puts the collateral organs at a greater risk of damage. The objective of this study is to carry out a comparison of the risk of cardiac complication in the right and left breasts of postmastectomy radiation therapy patients using radiobiological evaluation tools. Methods: Ninety-six patients treated in the University of Benin Teaching Hospital, RT Center, Nigeria, between January 2012 and March 2014 were recruited for this study. The relative seriality model was used to compute the risk of cardiac mortality to the breast of these patients. Results: The results showed that the equivalent uniform dose (EUD) to the heart for patients with left breast cancer is significantly (P < 0.05) higher than the EUD to the heart of patients with right breast and also the risk of cardiac mortality is significantly (P < 0.05) higher in the left breast than the right breast; due to proximity to the heart to the left side. Conclusion: This implies that the long-term risk of having cardiac disease should be of particular concern for women treated for left-sided breast cancer. As a result of this, care should be taken in planning patients using computerized treatment planning system that embraces imaging simulation rather than the conventional anatomical landmark; this will go a long way to prevent cardiac-induced mortality especially in cancer of the left breast.
{"title":"Radiobiological estimation of radiation-induced heart complication of postmastectomy radiation therapy patients using the relative seriality model","authors":"F. Adeyemi, E. Okungbowa","doi":"10.4103/WAJR.WAJR_59_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_59_17","url":null,"abstract":"Background and Aim: In Nigeria today, most radiotherapy (RT) centers do manual planning using anatomical landmarks rather than precise planning using imaging modalities such as Computerized Tomography and Magnetic Resonance Imaging. This puts the collateral organs at a greater risk of damage. The objective of this study is to carry out a comparison of the risk of cardiac complication in the right and left breasts of postmastectomy radiation therapy patients using radiobiological evaluation tools. Methods: Ninety-six patients treated in the University of Benin Teaching Hospital, RT Center, Nigeria, between January 2012 and March 2014 were recruited for this study. The relative seriality model was used to compute the risk of cardiac mortality to the breast of these patients. Results: The results showed that the equivalent uniform dose (EUD) to the heart for patients with left breast cancer is significantly (P < 0.05) higher than the EUD to the heart of patients with right breast and also the risk of cardiac mortality is significantly (P < 0.05) higher in the left breast than the right breast; due to proximity to the heart to the left side. Conclusion: This implies that the long-term risk of having cardiac disease should be of particular concern for women treated for left-sided breast cancer. As a result of this, care should be taken in planning patients using computerized treatment planning system that embraces imaging simulation rather than the conventional anatomical landmark; this will go a long way to prevent cardiac-induced mortality especially in cancer of the left breast.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49085683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Renal cysts are thin-walled sacs of fluid that form within the renal parenchyma which may be simple or complex. Most simple renal cysts are asymptomatic and are found usually incidentally by ultrasonography and computed tomography. However, a small proportion may become symptomatic with pain being the most common symptom. The aim of the study is to determine the prevalence of asymptomatic simple renal cysts in patients presenting for abdominal ultrasound (US) and the associations of simple renal cysts with age and gender. Materials and Methods: This was a retrospective study which involved the retrieval of the results of abdominal US performed at the Radiology Department of the University College Hospital between January 2013 and December 2015. Data extracted included age, sex, and renal sonographic findings. The retrieved data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0 software. Results: Two thousand and ninety-five patients had abdominal US done during the study period. The overall prevalence of asymptomatic simple renal cysts was 2.3% with the prevalence increasing with age (P < 0.001). Simple renal cysts were found in 2.3% of both males and females with a male-to-female ratio of 1:1.3. The mean widest diameter of renal cysts was 45 mm with a range between 15 mm and 105 mm. The cyst diameter tended to increase with age, but the correlation with age was not statistically significant (P = 0.278). The majority of the cysts were solitary (87.8%) with the right kidney having majority (59.2%) of the cysts. Conclusion: The overall prevalence of simple renal cyst in our study is 2.3% and it increased with age. Since simple renal cysts have been associated with some conditions and complications such as hypertension, polycythemia, hemorrhagic transformation, and cyst rupture, adequate follow-up is necessary to enable the prompt detection of complications and adequate intervention if the need arises.
{"title":"Prevalence of ultrasound-diagnosed asymptomatic simple renal cysts at the University College Hospital, Ibadan","authors":"J. Akinmoladun, A. Takure, O. Ogunleye","doi":"10.4103/WAJR.WAJR_58_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_58_17","url":null,"abstract":"Background: Renal cysts are thin-walled sacs of fluid that form within the renal parenchyma which may be simple or complex. Most simple renal cysts are asymptomatic and are found usually incidentally by ultrasonography and computed tomography. However, a small proportion may become symptomatic with pain being the most common symptom. The aim of the study is to determine the prevalence of asymptomatic simple renal cysts in patients presenting for abdominal ultrasound (US) and the associations of simple renal cysts with age and gender. Materials and Methods: This was a retrospective study which involved the retrieval of the results of abdominal US performed at the Radiology Department of the University College Hospital between January 2013 and December 2015. Data extracted included age, sex, and renal sonographic findings. The retrieved data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0 software. Results: Two thousand and ninety-five patients had abdominal US done during the study period. The overall prevalence of asymptomatic simple renal cysts was 2.3% with the prevalence increasing with age (P < 0.001). Simple renal cysts were found in 2.3% of both males and females with a male-to-female ratio of 1:1.3. The mean widest diameter of renal cysts was 45 mm with a range between 15 mm and 105 mm. The cyst diameter tended to increase with age, but the correlation with age was not statistically significant (P = 0.278). The majority of the cysts were solitary (87.8%) with the right kidney having majority (59.2%) of the cysts. Conclusion: The overall prevalence of simple renal cyst in our study is 2.3% and it increased with age. Since simple renal cysts have been associated with some conditions and complications such as hypertension, polycythemia, hemorrhagic transformation, and cyst rupture, adequate follow-up is necessary to enable the prompt detection of complications and adequate intervention if the need arises.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44474459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BlessingOse-Emenim Igbinedion, F. Ehigiamusoe, Stanley Ngoka
Nutcracker syndrome (NCS) occurs from compression of the left renal vein between the abdominal aorta and the superior mesenteric artery. It is rare and commonly presents with hematuria, flank pain, and dysuria. A 27-year-old male with sickle cell trait presented with a 9-month history of total hematuria complicated with anemia necessitating blood transfusion. He had no overt signs of urogenital infestation, renal impairment, or trauma. Genotype was AS. Intravenous urography was normal. On cystoscopy, the bleeding was seen to be coming through the left ureteral orifice. Renal angiography showed left renal venous stasis and contrast extravasation into the upper calyces. An impression of NCS was made. Other imaging modalities (computed tomography and ultrasound) supported NCS. NCS should be suspected in cases of recurrent hematuria.
{"title":"Nutcracker syndrome presenting as recurrent hematuria","authors":"BlessingOse-Emenim Igbinedion, F. Ehigiamusoe, Stanley Ngoka","doi":"10.4103/WAJR.WAJR_45_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_45_17","url":null,"abstract":"Nutcracker syndrome (NCS) occurs from compression of the left renal vein between the abdominal aorta and the superior mesenteric artery. It is rare and commonly presents with hematuria, flank pain, and dysuria. A 27-year-old male with sickle cell trait presented with a 9-month history of total hematuria complicated with anemia necessitating blood transfusion. He had no overt signs of urogenital infestation, renal impairment, or trauma. Genotype was AS. Intravenous urography was normal. On cystoscopy, the bleeding was seen to be coming through the left ureteral orifice. Renal angiography showed left renal venous stasis and contrast extravasation into the upper calyces. An impression of NCS was made. Other imaging modalities (computed tomography and ultrasound) supported NCS. NCS should be suspected in cases of recurrent hematuria.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44151914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Bhargava, Abhijit Patil, Vidhi Bakshi, T. Kalekar, Siddappa Gandage
Aim: The aim of this study is to determine utility of contrast-enhanced fluid-attenuated inversion recovery (FLAIR) imaging by comparing results with contrast-enhanced T1-weighted imaging (T1WI) in various intracranial lesions. Materials and Methods: Forty-nine patients with a known intracranial lesion or with clinical suspicion underwent the gadolinium-enhanced magnetic resonance (MR) imaging using 1.5T. Postcontrast axial, coronal, and sagittal T1 fat-saturated, axial FLAIR images were acquired after administration of gadobenate dimeglumine. The MR imaging parameters for the postcontrast T2-FLAIR images were 6000–9000/90–110/1845–2030 ms/150 (repetition time/echo time/inversion time/flip angle), and the acquisition time was 2 min 12 s. All images were acquired with a section thickness of 5 mm, an intersection gap of 2 mm, and a field of view of 256 mm × 144 mm. The images were transferred to a workstation and reviewed. Results: We found that postcontrast FLAIR images are useful by showing better meningeal involvement in various pathologies and enhancement of the solid component in intra-axial lesions. However, it was not much helpful in extra-axial lesions and lesions with mild postcontrast enhancement and lesions with perilesional edema. Conclusion: Postcontrast FLAIR is a useful adjunct to postcontrast T1W images in equivocal cases and for additional information.
目的：本研究的目的是通过比较对比增强T1加权成像（T1WI）与液体衰减反转恢复（FLAIR）成像在各种颅内病变中的效果，来确定FLAIR成像的实用性。材料和方法：49例已知颅内病变或临床怀疑的患者使用1.5T进行了钆增强磁共振（MR）成像。在给药加多酚丁胺后，获得T1轴向、冠状和矢状脂肪饱和的轴向FLAIR图像。对比后T2-FLAIR图像的MR成像参数为6000–9000/90–110/1845–2030 ms/150（重复时间/回波时间/反转时间/翻转角度），采集时间为2 min 12 s。所有图像的采集截面厚度为5 mm，交叉间隙为2 mm，视场为256 mm×144 mm。将图像转移到工作站并进行审查。结果：我们发现，增强后FLAIR图像显示脑膜在各种病理中的更好受累和轴内病变中实体成分的增强是有用的。然而，它对轴外病变、轻度造影后增强的病变和病变周围水肿的病变没有太大帮助。结论：在可疑病例中，对比后FLAIR是对比后T1W图像的有用辅助手段，并可获得更多信息。
{"title":"Utility of contrast-enhanced fluid-attenuated inversion recovery in magnetic resonance imaging of intracranial lesions","authors":"R. Bhargava, Abhijit Patil, Vidhi Bakshi, T. Kalekar, Siddappa Gandage","doi":"10.4103/WAJR.WAJR_4_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_4_17","url":null,"abstract":"Aim: The aim of this study is to determine utility of contrast-enhanced fluid-attenuated inversion recovery (FLAIR) imaging by comparing results with contrast-enhanced T1-weighted imaging (T1WI) in various intracranial lesions. Materials and Methods: Forty-nine patients with a known intracranial lesion or with clinical suspicion underwent the gadolinium-enhanced magnetic resonance (MR) imaging using 1.5T. Postcontrast axial, coronal, and sagittal T1 fat-saturated, axial FLAIR images were acquired after administration of gadobenate dimeglumine. The MR imaging parameters for the postcontrast T2-FLAIR images were 6000–9000/90–110/1845–2030 ms/150 (repetition time/echo time/inversion time/flip angle), and the acquisition time was 2 min 12 s. All images were acquired with a section thickness of 5 mm, an intersection gap of 2 mm, and a field of view of 256 mm × 144 mm. The images were transferred to a workstation and reviewed. Results: We found that postcontrast FLAIR images are useful by showing better meningeal involvement in various pathologies and enhancement of the solid component in intra-axial lesions. However, it was not much helpful in extra-axial lesions and lesions with mild postcontrast enhancement and lesions with perilesional edema. Conclusion: Postcontrast FLAIR is a useful adjunct to postcontrast T1W images in equivocal cases and for additional information.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48847960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kidney trauma occurs in approximately 1%–5% of all traumas with the male preponderance. The consequences of blunt renal trauma range from a simple contusion or renal hematoma to complete shattering of the organ or avulsion of the vascular pedicle. Recently, there is more focus on conservative management as newer techniques evolve and its currently the preferred approach to most renal injuries; however, surgery is the main treatment modality for avulsion of the renal pelvis, injuries to the vascular pedicle, and life-threatening hemodynamic instability. Renal artery embolization is a minimally invasive procedure used in the management of many disease conditions and also to control hemorrhage. We report of a Grade 5 renal injury with hemodynamic instability managed with renal artery embolization which otherwise would have been managed with surgery. A 33-year-old presented with Grade 5 left renal injury and hemodynamic instability after a fall. Computed tomography of the abdomen after resuscitation showed shattered left kidney with disruption of the renal hilum and features suggestive of active bleeding. Due to the hypovolemic nature of the patient, embolization of the renal artery was requested. With anesthetic support and antibiotic cover, the right common femoral artery was punctured and a 5 French sheath inserted. Both left renal arteries were selectively catheterized and embolized to stasis with coils. An Angio-Seal device was deployed in the groin and no immediate complications seen. The patient was discharged few days after. This case report shows that Grade 5 renal artery can also be managed through a minimal invasive procedure to reduce the length of time at the hospital and also reduce the metabolic response of the patient.
{"title":"A case of renal artery embolization for Grade 5 renal injury, usually reserved for surgery","authors":"A. Hammond","doi":"10.4103/WAJR.WAJR_32_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_32_17","url":null,"abstract":"Kidney trauma occurs in approximately 1%–5% of all traumas with the male preponderance. The consequences of blunt renal trauma range from a simple contusion or renal hematoma to complete shattering of the organ or avulsion of the vascular pedicle. Recently, there is more focus on conservative management as newer techniques evolve and its currently the preferred approach to most renal injuries; however, surgery is the main treatment modality for avulsion of the renal pelvis, injuries to the vascular pedicle, and life-threatening hemodynamic instability. Renal artery embolization is a minimally invasive procedure used in the management of many disease conditions and also to control hemorrhage. We report of a Grade 5 renal injury with hemodynamic instability managed with renal artery embolization which otherwise would have been managed with surgery. A 33-year-old presented with Grade 5 left renal injury and hemodynamic instability after a fall. Computed tomography of the abdomen after resuscitation showed shattered left kidney with disruption of the renal hilum and features suggestive of active bleeding. Due to the hypovolemic nature of the patient, embolization of the renal artery was requested. With anesthetic support and antibiotic cover, the right common femoral artery was punctured and a 5 French sheath inserted. Both left renal arteries were selectively catheterized and embolized to stasis with coils. An Angio-Seal device was deployed in the groin and no immediate complications seen. The patient was discharged few days after. This case report shows that Grade 5 renal artery can also be managed through a minimal invasive procedure to reduce the length of time at the hospital and also reduce the metabolic response of the patient.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45943548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olubukola Titilayo Omidiji, O. Ojo, A. Adeyomoye, O. Atalabi, F. Okwuegbuna
Context: Congenital brain anomalies are of diverse types however few are seen in clinical practice. They are associated with high morbidity and mortality; prompt diagnosis and management aid in mitigating some of their adverse effects. Magnetic resonance imaging (MRI) is ideal for imaging these conditions, especially in pediatric cases due to its lack of ionizing radiation and excellent soft-tissue delineation. Not much literature exists for Nigeria due to challenges with statistics and record keeping. Aim: The aim of this study is to document the common congenital brain anomalies encountered using MRI in our environment. Settings and Design: A 5-year retrospective study of all pediatric brain MRI conducted and reviewed in Lagos University Teaching Hospital. 73 pediatric brain MRI scans were reviewed. Materials and Methods: Morphologic evaluation of all pediatric brain MRI conducted in the last 5 years (March 2012–February 2016) was reviewed, retrospectively, by three independent radiologists. Clinical presentations were also documented. Statistical Analysis Used: Descriptive statistics was done using SPSS: PASW Statistics for Windows, Version 18.0 Results: Seventy-three pediatric brain MRI scans were conducted in the last 5 years with congenital brain anomalies seen in 19 (26.0%) of the cases. Their ages ranged from 3 months to 17 years with a mean age of 6.7 ± 6.1 years. There were 9 (47.4%) males and 10 (52.6%) females. The common anomalies are congenital hydrocephalus 7 (35%), of which aqueductal stenosis was 6 (32%), arteriovenous malformations 3 (16%), cerebral atrophy 3 (16%), and arachnoid cysts 2 (11%). Predominant clinical features were delayed developmental milestones, macrocephaly, seizures, headaches, and vomiting. Conclusion: The common congenital brain anomalies in our environment are congenital hydrocephalus, aqueductal stenosis, arteriovenous malformations, cerebral atrophy and arachnoid cysts. MRI is useful in evaluating these anomalies; early diagnosis and prompt intervention can be offered to mitigate adverse effects.
背景:先天性脑异常类型多样，但在临床实践中很少见到。它们与高发病率和高死亡率有关;及时诊断和治疗有助于减轻一些不良影响。磁共振成像(MRI)是理想的成像这些条件，特别是在儿科病例中，由于其缺乏电离辐射和良好的软组织描绘。由于统计和记录方面的挑战，关于尼日利亚的文献并不多。目的:本研究的目的是记录在我们的环境中使用MRI遇到的常见先天性脑异常。背景和设计:在拉各斯大学教学医院进行的一项为期5年的儿童脑MRI回顾性研究，回顾了73份儿童脑MRI扫描。材料与方法:由三名独立放射科医师回顾性回顾近5年(2012年3月- 2016年2月)所有小儿脑MRI的形态学评价。临床表现也被记录。使用SPSS: PASW statistics for Windows, Version 18.0进行描述性统计结果:近5年共进行73例小儿脑MRI扫描，其中19例(26.0%)出现先天性脑异常。年龄3个月~ 17岁，平均6.7±6.1岁。男性9例(47.4%)，女性10例(52.6%)。常见的畸形有先天性脑积水7例(35%)，其中导水管狭窄6例(32%)，动静脉畸形3例(16%)，脑萎缩3例(16%)，蛛网膜囊肿2例(11%)。主要临床特征为发育里程碑延迟、大头畸形、癫痫发作、头痛和呕吐。结论:先天性脑积水、导水管狭窄、动静脉畸形、脑萎缩和蛛网膜囊肿是我们环境中常见的先天性脑异常。MRI可用于评估这些异常;可以提供早期诊断和及时干预以减轻不良反应。
{"title":"Magnetic resonance imaging pattern of congenital brain anomalies in the neurosurgery department of a teaching hospital in Nigeria: An initial experience","authors":"Olubukola Titilayo Omidiji, O. Ojo, A. Adeyomoye, O. Atalabi, F. Okwuegbuna","doi":"10.4103/WAJR.WAJR_15_17","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_15_17","url":null,"abstract":"Context: Congenital brain anomalies are of diverse types however few are seen in clinical practice. They are associated with high morbidity and mortality; prompt diagnosis and management aid in mitigating some of their adverse effects. Magnetic resonance imaging (MRI) is ideal for imaging these conditions, especially in pediatric cases due to its lack of ionizing radiation and excellent soft-tissue delineation. Not much literature exists for Nigeria due to challenges with statistics and record keeping. Aim: The aim of this study is to document the common congenital brain anomalies encountered using MRI in our environment. Settings and Design: A 5-year retrospective study of all pediatric brain MRI conducted and reviewed in Lagos University Teaching Hospital. 73 pediatric brain MRI scans were reviewed. Materials and Methods: Morphologic evaluation of all pediatric brain MRI conducted in the last 5 years (March 2012–February 2016) was reviewed, retrospectively, by three independent radiologists. Clinical presentations were also documented. Statistical Analysis Used: Descriptive statistics was done using SPSS: PASW Statistics for Windows, Version 18.0 Results: Seventy-three pediatric brain MRI scans were conducted in the last 5 years with congenital brain anomalies seen in 19 (26.0%) of the cases. Their ages ranged from 3 months to 17 years with a mean age of 6.7 ± 6.1 years. There were 9 (47.4%) males and 10 (52.6%) females. The common anomalies are congenital hydrocephalus 7 (35%), of which aqueductal stenosis was 6 (32%), arteriovenous malformations 3 (16%), cerebral atrophy 3 (16%), and arachnoid cysts 2 (11%). Predominant clinical features were delayed developmental milestones, macrocephaly, seizures, headaches, and vomiting. Conclusion: The common congenital brain anomalies in our environment are congenital hydrocephalus, aqueductal stenosis, arteriovenous malformations, cerebral atrophy and arachnoid cysts. MRI is useful in evaluating these anomalies; early diagnosis and prompt intervention can be offered to mitigate adverse effects.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44183398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Agrawal, G. Bo, M. Bhattarai, Shankar P. Shah, M. Agrawal
Objective: To evaluate the diagnostic features in differentiating malignant from benign common bile duct (CBD) strictures using contrast-enhanced multidetector computed tomography (MDCT). Patients and Methods: An ambispective study from January 1, 2008 to December 31, 2010, on fifty patients with liver function tests suggestive of obstructive jaundice and an ultrasound showing biliary obstruction were included. A nonenhanced computed tomography (CT) was done before the administration of the contrast medium and then scans were routinely obtained in four phases: early arterial , late arterial, portal venous, and delayed phases. The CT scans acquired were reviewed on a picture archiving and communication system workstation. CT findings were interpreted with regard to wall thickness, the location, length involved, enhancement pattern, presence of invasion, and margins of the stricture. These were compared with the attenuation of the normal CBD wall, the maximum CBD diameter proximal, and pancreatic duct dilatation. Results: The mean age ± standard deviation of patients was 62.84 ± 11.61 years (range: 38–82 years). Among the fifty patients included in the study, 31 (62%) had malignant CBD stricture. The involved segments of malignant CBD strictures were significantly longer with significantly larger maximum proximal CBD diameter, considerably thicker and irregular stricture wall and showing more enhancement during delayed phase. No significant differences were found between malignant and benign CBD strictures with respect to stricture location. Conclusions: Presence of irregular margins, invasion into neighboring tissues, long-segment involvement, more proximal CBD dilatation, and hyperenhancement in delayed and portal venous phases in contrast-enhanced MDCT helps in the differentiation of malignant from benign CBD strictures.
{"title":"Role of multidetector computed tomography in differentiating benign and malignant common bile duct strictures","authors":"P. Agrawal, G. Bo, M. Bhattarai, Shankar P. Shah, M. Agrawal","doi":"10.4103/WAJR.WAJR_57_16","DOIUrl":"https://doi.org/10.4103/WAJR.WAJR_57_16","url":null,"abstract":"Objective: To evaluate the diagnostic features in differentiating malignant from benign common bile duct (CBD) strictures using contrast-enhanced multidetector computed tomography (MDCT). Patients and Methods: An ambispective study from January 1, 2008 to December 31, 2010, on fifty patients with liver function tests suggestive of obstructive jaundice and an ultrasound showing biliary obstruction were included. A nonenhanced computed tomography (CT) was done before the administration of the contrast medium and then scans were routinely obtained in four phases: early arterial , late arterial, portal venous, and delayed phases. The CT scans acquired were reviewed on a picture archiving and communication system workstation. CT findings were interpreted with regard to wall thickness, the location, length involved, enhancement pattern, presence of invasion, and margins of the stricture. These were compared with the attenuation of the normal CBD wall, the maximum CBD diameter proximal, and pancreatic duct dilatation. Results: The mean age ± standard deviation of patients was 62.84 ± 11.61 years (range: 38–82 years). Among the fifty patients included in the study, 31 (62%) had malignant CBD stricture. The involved segments of malignant CBD strictures were significantly longer with significantly larger maximum proximal CBD diameter, considerably thicker and irregular stricture wall and showing more enhancement during delayed phase. No significant differences were found between malignant and benign CBD strictures with respect to stricture location. Conclusions: Presence of irregular margins, invasion into neighboring tissues, long-segment involvement, more proximal CBD dilatation, and hyperenhancement in delayed and portal venous phases in contrast-enhanced MDCT helps in the differentiation of malignant from benign CBD strictures.","PeriodicalId":29875,"journal":{"name":"West African Journal of Radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48905046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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